Estimation and comparison of the radiation effective dose during coronary computed tomography angiography examinations on single-source 64-MDCT and dual-source 128-MDCT

Radiation Exposure and Lifetime Attributable Risk of Cancer Incidence and Mortality from Low- and Standard-Dose CT Chest: Implications for COVID-19 Pneumonia Subjects

Since the novel coronavirus disease 2019 (COVID-19) outbreak, there has been an unprecedented increase in the acquisition of chest computed tomography (CT) scans. Nearly 616 million people have been infected by COVID-19 worldwide to date, of whom many were subjected to CT scanning. CT exposes the patients to hazardous ionizing radiation, which can damage the genetic material in the cells, leading to stochastic health effects in the form of heritable genetic mutations and increased cancer risk. These probabilistic, long-term carcinogenic effects of radiation can be seen over a lifetime and may sometimes take several decades to manifest. This review briefly describes what is known about the health effects of radiation, the lowest dose for which there exists compelling evidence about increased radiation-induced cancer risk and the evidence regarding this risk at typical CT doses. The lifetime attributable risk (LAR) of cancer from low- and standard-dose chest CT scans performed in COVID-19 subjects is also discussed along with the projected number of future cancers that could be related to chest CT scans performed during the COVID-19 pandemic. The LAR of cancer Incidence from chest CT has also been compared with those from other radiation sources, daily life risks and lifetime baseline risk.

COMPARISON OF RADIATION DOSE AND IMAGE QUALITY IN HEAD CT SCANS AMONG MULTIDETECTOR CT SCANNERS

The present study compares three different multidetector CT (MDCT) scanners for routine brain imaging in terms of image quality and radiation doses. The volume CT dose index (CTDIvol), dose-length product (DLP), and effective dose (E) were calculated. Subjective image assessment was obtained based on a scale ranging from 1 (unacceptable) to 5 (optimum). All images scored 3.5 or over, with the 160-slice MDCT images being favoured. For the 4-, 16- and 160-slice MDCT scanners, the respective median values for CTDIvol were 57 mGy, 41 mGy, and 28 mGy; DLP values were 901 mGy.cm, 680 mGy.cm, and 551 mGy.cm; and effective doses were 2 mSv, 1.5 mSv, and 1 mSv, respectively. Compared to the 160-slice MDCT, the dose values for the 4- and 16-slice units were significantly greater. In practice, the CT modality used must be carefully selected to avoid elevated radiation doses and maintain image quality.

A review on chest CT scanning parameters implemented in COVID-19 patients: bringing low-dose CT protocols into play

Background

This study aims to review chest computed tomography (CT) scanning parameters which are utilized to evaluate patients for COVID-19-induced pneumonia. Also, some of radiation dose reduction techniques in CT would be mentioned, because using these techniques or low-dose protocol can decrease the radiation burden on the population.

Main body

Chest CT scan can play a key diagnostic role in COVID-19 patients. Additionally, it can be useful to monitor imaging changes during treatment. However, CT scan overuse during the COVID-19 pandemic raises concerns about radiation-induced adverse effects, both in patients and healthcare workers.

Conclusion

By evaluating the CT scanning parameters used in several studies, one can find the necessity for optimizing these parameters. It has been found that chest CT scan taken using low-dose CT protocol is a reliable diagnostic tool to detect COVID-19 pneumonia in daily practice. Moreover, the low-dose chest CT protocol results in a remarkable reduction (up to 89%) in the radiation dose compared to the standard-dose protocol, not lowering diagnostic accuracy of COVID-19-induced pneumonia in CT images. Therefore, its employment in the era of the COVID-19 pandemic is highly recommended.

Patient-Specific Organ and Effective Dose Estimates in Adult Oncologic CT

OBJECTIVE. Patient-specific organ and effective dose provides essential information for CT protocol optimization. However, such information is not readily available in the scan records. The purpose of this study was to develop a method to obtain accurate examination- and patient-specific organ and effective dose estimates by use of available scan data and patient body size information for a large cohort of patients. MATERIALS AND METHODS. The data were randomly collected for 1200 patients who underwent CT in a 2-year period. Physical characteristics of the patients and CT technique were processed as inputs for the dose estimator. Organ and effective doses were estimated by use of the inputs and computational human phantoms matched to patients on the basis of sex and effective diameter. Size-based ratios were applied to correct for patient-phantom body size differences. RESULTS. Patients received a mean of 59.9 mGy to the lens of the eye per brain scan, 10.1 mGy to the thyroid per chest scan, 17.5 mGy to the liver per abdomen and pelvis scan, and 19.0 mGy to the liver per body scan. A factor of 2 difference in dose estimates was observed between patients of various habitus. CONCLUSION. Examination- and patient-specific organ and effective doses were estimated for 1200 adult oncology patients undergoing CT. The dose conversion factors calculated facilitate rapid organ and effective dose estimation in clinics. Compared with nonspecific dose estimation methods, patient dose estimations with data specific to the patient and examination can differ by a factor of 2.

Establishment of diagnostic reference levels arising from common CT examinations in Semnan County, Iran

Objective: The literature has approved that the use of the concept of diagnostic reference level (DRL) as a part of an optimization process could help to reduce patient doses in diagnostic radiology comprising the Computed Tomography (CT) examinations. There are four public/governmental CT centers in the province (Semnan, Iran) and, to our knowledge, after about 12 years since the launch of the first CT scanner in the province there is no dosimetry information on those CT scanners. The aim of this study was to evaluate CT dose indices with the aim of the establishment of the DRL for head, chest, cervical spine, and abdomen-pelvis examinations.

Methods: Scan parameters of 381 patients were collected during two months from 4 CT scanners. The CT dose index (CTDI) was measured using a calibrated ionization chamber on two cylindrical poly methyl methacrylate (PMMA) phantoms. For each sequences, weighted CTDI (CTDIw), volumetric CTDI (CTDIv) and dose length product (DLP) were calculated. The 75th percentile was proposed as the criterion for DRL values.

Results: Proposed DRL (CTDIw, CTDIv, DLP) for the head, chest, cervical spine, and abdomen-pelvis were (46.1 mGy, 46.1 mGy, 723 mGy × cm), (13.8 mGy, 12.0 mGy, 377 mGy × cm), (40.0 mGy, 40.0 mGy, 572 mGy × cm) and (14.9 mGy, 12.1 mGy, 524 mGy × cm), respectively.

Conclusion: Comparison with the others results from the other countries indicates that the head, chest and abdomen-pelvis scans in our region are lower or in the range of the other studies investigated in terms of dose. In the case of cervical spine scanning it’s necessary to review and regulate scan protocols to reach acceptable dose levels.